The role of cherries in exercise and health

Effects of Nutrition Interventions on Athletic Performance in Soccer Players: A Systematic Review

BACKGROUND

More than 270 million participants and 128,893 professional players play soccer. Although UEFA recommendations for nutrition in elite football exist, implementing these guidelines among professional and semiprofessional soccer players remains suboptimal, emphasizing the need for targeted and individualized nutritional strategies to improve adherence to established recommendations.

METHODS

We conducted a comprehensive search in PubMed, Scopus, Web of Science, and clinical trial registers. Inclusion criteria focused on professional or semiprofessional soccer players, nutrition or diet interventions, performance improvement outcomes, and randomized clinical trial study types. We assessed quality using the Risk of Bias 2 (RoB 2) tool. We identified 16 eligible articles involving 310 participants. No nutritional interventions during the recovery period effectively improved recovery. However, several performance-based interventions showed positive effects, such as tart cherry supplementation, raw pistachio nut kernels, bicarbonate and mineral ingestion, creatine supplementation, betaine consumption, symbiotic supplements, and a high-carbohydrate diet. These interventions influenced various aspects of soccer performance, including endurance, speed, agility, strength, power, explosiveness, and anaerobic capacity.

CONCLUSIONS

Specific strategies, such as solutions with bicarbonate and minerals, high carbohydrate diets, and supplements like creatine, betaine, and tart cherry, can enhance the performance of professional soccer players. These targeted nutritional interventions may help optimize performance and provide the competitive edge required in professional soccer. We did not find any dietary interventions that could enhance recovery.

Cold water immersion after a soccer match: Does the placebo effect occur?

Although cold water immersion (CWI) is one of the most widely used post-exercise strategies to accelerate recovery processes, the benefits of CWI may be associated with placebo effects. This study aimed to compare the effects of CWI and placebo interventions on time course of recovery after the Loughborough Intermittent Shuttle Test (LIST). In a randomized, counterbalanced, crossover study, twelve semi-professional soccer players (age 21.1 ± 2.2 years, body mass 72.4 ± 5.9 kg, height 174.9 ± 4.6 cm, V ˙ O_2max 56.1 ± 2.3 mL/min/kg) completed the LIST followed by CWI (15 min at 11°C), placebo (recovery Pla beverage), and passive recovery (Rest) over three different weeks. Creatine kinase (CK), C-reactive protein (CRP), uric acid (UA), delayed onset muscle soreness (DOMS), squat jump (SJ), countermovement jump (CMJ), 10-m sprint (10 mS), 20-m sprint (20 mS) and repeated sprint ability (RSA) were assessed at baseline and 24 and 48 h after the LIST. Compared to baseline, CK concentration was higher at 24 h in all conditions (p < 0.01), while CRP was higher at 24 h only in CWI and Rest conditions (p < 0.01). UA was higher for Rest condition at 24 and 48 h compared to Pla and CWI conditions (p < 0.001). DOMS score was higher for Rest condition at 24 h compared to CWI and Pla conditions (p = 0.001), and only to Pla condition at 48 h (p = 0.017). SJ and CMJ performances decreased significantly after the LIST in Rest condition (24 h: -7.24%, p = 0.001 and -5.45%, p = 0.003 respectively; 48 h: -9.19%, p < 0.001 and -5.70% p = 0.002 respectively) but not in CWI and Pla conditions. 10 mS and RSA performance were lower for Pla at 24 h compared to CWI and Rest conditions (p < 0.05), while no significant change was observed for 20 mS time. These data suggests that CWI and Pla intervention were more effective than the Rest conditions in recovery kinetics of muscle damage markers and physical performance. Furthermore, the effectiveness of CWI would be explained, at least in part, by the placebo effect.

Effects of chronic consumption of specific fruit (berries, cherries and citrus) on cognitive health: a systematic review and meta-analysis of randomised controlled trials

OBJECTIVES

The cognitive-protective effects related to the consumption of a variety of fruits are supported by several intervention studies. This systematic review and meta-analysis compared the magnitude of effects following chronic (≥1 week) consumption of frozen, freeze-dried powder including extracts and juices of fruits, covering berries, cherries and citrus, on cognition and mood in adults.

METHODS

PubMed, Web of Science, Scopus, and psycARTICLES were searched from inception until February, 2021. Inclusion criteria were randomised controlled trials assessing memory, executive function, psychomotor speed, mood and mini mental state examination in adult participants ≥18 years of age. Cognition was tested by global or domain specific tasks.

RESULTS

Out of 13,861 articles identified, 16 papers were included; 11 studies provided suitable data for meta-analysis. Fourteen studies reported improvement or trend for improvement in cognition, five studies assessed mood and one study supplementing grape juice found trend for mood improvement. From the meta-analysis, cherry juice supplementation was suggested to improve psychomotor speed by -0.37 of standardised mean difference (95% CI [-0.74, 0.01]) in reaction time (P = 0.05).

CONCLUSIONS

The meta-analysis did not sufficiently support a role for fruits or fruit forms to improve cognition and mood.

Effects of tart cherry juice consumption on cardio-metabolic risk factors: A systematic review and meta-analysis of randomized-controlled trials

BACKGROUND

Tart cherries are rich in bioactive compounds, such as anthocyanins and other phytochemicals known to have antioxidant properties and exert cardiovascular protective effects. However, there is no definitive consensus on this context. The present systematic review and meta-analysis aimed to investigate the effect of tart cherry juice consumption on cardio-metabolic risk factors.

METHODS

A systematic search was conducted on electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar from inception up to December 2021 to identify eligible RCT studies. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI).

RESULTS

Ten RCTs were included in the present meta-analysis. The pooled analysis revealed that tart cherry juice consumption led to a significant reduction in the fasting blood sugar (FBS) levels (WMD = -0.51 mg/dl [95% CI: -0.98, -0.06]). This lowering effect of FBS was robust in subgroups with cross-over studies, participants with age range ≥ 40, duration of follow-up ≤ 4 weeks, and baseline BMI ≥ 30. In contrast, tart cherry juice had no effect on total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), insulin, body mass index (BMI), fat mass, systolic and diastolic blood pressure. However, in the subgroup analysis, some significant effects were observed for insulin, TG, TC, LDL-C, and HDL-C.

CONCLUSION

In summary, this meta-analysis showed that tart cherry juice mostly had a favorable effect on FBG levels. However, further RCTs with long-term intervention with different doses of administration are needed.

Practical Nutrition Strategies to Support Basketball Performance during International Short-Term Tournaments: A Narrative Review

A short-term (e.g., 6 days) basketball tournament is a shorter version of international tournaments, and qualification in it enables participation in international tournaments such as the Olympics and World championships or preparation before major tournaments. Time for recovery between matches is shorter compared with major tournaments, resulting in an accentuated load on players, which can be repeated up to four times within the 6-day competition period. Therefore, nutritional strategies need to focus on faster and adequate recovery after each match as well as optimum fuelling and hydration before and during matches. Travelling can also create additional challenges when preparing and/or applying those nutritional strategies. There are some particular evidence-based sport foods and ergogenic aids that can improve intermittent activity and/or the execution of motor skills, which may facilitate basketball players' recovery and performance. The present review provides practical nutritional strategies to support short-term basketball tournaments based on players' physiological needs and current sport nutrition guidelines.

Options for the generation of seedless cherry, the ultimate snacking product

This manuscript identifies cherry orthologues of genes implicated in the development of pericarpic fruit and pinpoints potential options and restrictions in the use of these targets for commercial exploitation of parthenocarpic cherry fruit. Cherry fruit contain a large stone and seed, making processing of the fruit laborious and consumption by the consumer challenging, inconvenient to eat 'on the move' and potentially dangerous for children. Availability of fruit lacking the stone and seed would be potentially transformative for the cherry industry, since such fruit would be easier to process and would increase consumer demand because of the potential reduction in costs. This review will explore the background of seedless fruit, in the context of the ambition to produce the first seedless cherry, carry out an in-depth analysis of the current literature around parthenocarpy in fruit, and discuss the available technology and potential for producing seedless cherry fruit as an 'ultimate snacking product' for the twenty-first century.

Effectiveness of Nitrate Intake on Recovery from Exercise-Related Fatigue: A Systematic Review

BACKGROUND

Recovery between efforts is critical to achieving optimal physical and sports performance. In this sense, many nutritional supplements that have been proven to improve recovery and physical and physiological performance are widely used. Supplements such as nitrates (NO₃^-), including organic foods such as beets, promote muscle recovery and relieve fatigue. This study aimed to comprehensively summarise the available literature on the effect of NO₃^- consumption on exercise-related fatigue and muscle damage.

METHODS

A systematic search was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) using electronic databases (e.g., PubMed, Scopus, and Web of Science). From a total of 1634 studies identified, 15 studies were included in this review.

RESULTS

Based on the review, NO₃^- intake provokes physiological and metabolic responses that could potentially boost exercise-related recovery. NO₃^- could improve recovery indicators related to strength, pain, inflammation, and muscle damage.

CONCLUSIONS

Despite the relative proven effectiveness of NO₃^- on recovery after aerobic and anaerobic efforts, based on the heterogeneity of the procedures (e.g., dosage, chronic vs. acute intake, participants' characteristics, variables and outcomes), it could be premature to suggest its extended use in sports.

A combination of cherry juice and cold water immersion does not enhance marathon recovery compared to either treatment in isolation: A randomized placebo-controlled trial

Purpose

Cherry juice (CJ) and cold water immersion (CWI) are both effective recovery strategies following strenuous endurance exercise. However, athletes routinely combine recovery interventions and less is known about the impact of a combined CJ and CWI protocol. Therefore, this study investigated the effects of combining CWI and CJ (a “cocktail” (CT)) on inflammation and muscle damage following a marathon.

Methods

A total 39 endurance trained males were randomly assigned to a placebo (PL), CWI, CJ, or CT group before completing a trail marathon run. Muscle damage (creatine kinase (CK)), muscle function (maximal voluntary isometric contraction (MVIC)), and inflammation (interleukin-6 (IL-6); C-reactive protein (CRP)) were measured at baseline, immediately after marathon (only IL-6), 24 h, and 48 h after marathon.

Results

There were no statistically significant differences between groups and no group × time interaction effects for any of the dependent variables. Confidence intervals (CI) illustrated that CT had unclear effects on inflammation (IL-6; CRP) and MVIC, but may have increased CK to a greater extent than PL and CJ conditions.

Conclusion

There is no evidence of an additive effect of CJ and CWI when the treatments are used in conjunction with each other. On the contrary, combining CJ and CWI may result in slightly increased circulating CK.

Fruit Development in Sweet Cherry

Fruits are an important source of vitamins, minerals and nutrients in the human diet. They also contain several compounds of nutraceutical importance that have significant antioxidant and anti-inflammatory roles, which can protect the consumer from diseases, such as cancer, and cardiovascular disease as well as having roles in reducing the build-up of LDL-cholesterol in blood plasma and generally reduce the risks of disease and age-related decline in health. Cherries contain high concentrations of bioactive compounds and minerals, including calcium, phosphorous, potassium and magnesium, and it is, therefore, unsurprising that cherry consumption has a positive impact on health. This review highlights the development of sweet cherry fruit, the health benefits of cherry consumption, and the options for increasing consumer acceptance and consumption.

Improved Endurance Running Performance Following Haskap Berry (Lonicera caerulea L.) Ingestion

BACKGROUND

Food high in (poly)phenolic compounds, such as anthocyanins, have the potential to improve exercise recovery and exercise performance. Haskap berries are rich in anthocyanins, but no research has examined the potential to improve human performance. The aim of this study was to determine the influence of Haskap berry on parameters of endurance running performance.

METHODS

Using a double-blind, placebo controlled, independent groups design, 30 male recreational runners (mean ± SD age, 33 ± 7 years; stature, 178.2 ± 7.2 cm; mass, 77.7 ± 10.6 kg; V˙O2peak, 52.2 ± 6.6 mL/kg/min) volunteered to participate. Following familiarisation, volunteers visited the laboratory twice (separated by seven days) to assess submaximal, maximal and 5 km time trial running performance. After the first visit, volunteers were randomly assigned to consume either the Haskap berry intervention or an isocaloric placebo control.

RESULTS

There were modest changes in heart rate and V˙O2 at submaximal intensities (p < 0.05). Time to exhaustion during the V˙O2peak test was longer in the Haskap group by 20 s (p = 0.031). Additionally, 5 km time trial performance was improved in the Haskap group by ~21 s (p = 0.016), which equated to a 0.25 km/h increase in mean running speed compared to the placebo control; this represented a >2% improvement in running performance.

CONCLUSIONS

The application of this newly identified functional food to athletes has the capacity to improve endurance running performance.

"Precovery" Versus Recovery: Understanding the role of cherry juice in exercise recovery

Cherry juice has become a standard component of athlete recovery strategies. This review covers the history of cherry juice as a recovery drink to give context to its current use. Fifteen studies were identified that included a measure of muscle function, soreness, or inflammation on the days following exercise and had an exercise insult sufficient to assess the effectiveness of the tart cherry intervention. Eight studies used a concentrated juice, three used a juice from fresh‐frozen cherries, two used a tart cherry concentrate gel, and two used a tart cherry powder. The effective juice dose was specific to the type of drink (fresh‐frozen versus concentrate) but dose‐response studies are lacking, and thus, the optimal dose for any specific type of cherry juice is not known. Timing of the dosing regimen is a critical factor. Studies have uniformly shown that muscle function will recover faster on the days after exercise if juice is provided for several days prior to exercise. Effects on soreness or systemic inflammation are more equivocal. The available evidence does not support a regimen that begins on the day of exercise or post‐exercise. Tart cherry powder did not enhance any metric of recovery on the days after exercise. In conclusion, the term recovery implies an intervention that is introduced after an exercise insult. The term “precovery” may be preferable to describe interventions that should be introduced on the days prior to exercise to facilitate recovery on the days after exercise. The evidence supports cherry juice as a precovery intervention across a range of athletic activities.

Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans

Dietary supplements are widely used as a nutritional strategy to improve and maintain performance and achieve faster recovery in sports and exercise. Exercise-induced muscle damage (EIMD) is caused by mechanical stress and subsequent inflammatory responses including reactive oxygen species and cytokine production. Therefore, dietary supplements with anti-inflammatory and antioxidant properties have the potential to prevent and reduce muscle damage and symptoms characterized by loss of muscle strength and delayed-onset muscle soreness (DOMS). However, only a few supplements are considered to be effective at present. This review focuses on the effects of dietary supplements derived from phytochemicals and listed in the International Olympic Committee consensus statement on muscle damage evaluated by blood myofiber damage markers, muscle soreness, performance, and inflammatory and oxidative stress markers. In this review, the effects of dietary supplements are also discussed in terms of study design (i.e., parallel and crossover studies), exercise model, and such subject characteristics as physical fitness level. Future perspectives and considerations for the use of dietary supplements to alleviate EIMD and DOMS are also discussed.

Regular, but not acute, green tea supplementation increases total antioxidant status and reduces exercise-induced oxidative stress: a systematic review

This systematic review aims to investigate the effects of green tea supplementation on exercise-induced oxidative stress. Four electronic databases were searched from inception to December 2020: SPORTDiscuss, PubMed, Scopus, and Web of Science. The search strategy was established in the following manner: (green tea) (Title/Abstract) AND (exercise OR training) (Title/Abstract) AND (oxidative stress OR antioxidant OR oxidation) (Title). After the application of inclusion and exclusion criteria 11, randomized or non-randomized control trials were included, 6 with a parallel design and 5 with a crossover design. Study methodological quality was assessed with the PEDro scale, and all studies were considered of moderate quality. Overall, acute green tea ingestion does not appear to influence antioxidant status or reduce exercise-induced oxidative stress. In contrast, green tea supplementation before exercise, for periods of more than 1 week, in a dose range of 400 to 800 mg of catechins per day, appears to be efficacious to increase total antioxidant status and protect cells against exercise-induced oxidative stress. Future investigations should focus on beginning green tea supplementation more than 7 days before exercise and completing it 2 or 3 days after while monitoring the change of markers of oxidative stress up to 48-72 h after exercise.

Potential Role of Cannabidiol on Sports Recovery: A Narrative Review

The use of cannabidiol (CBD) among athletes is becoming extensive and frequent. This could be due to the elimination of CBD from the list of prohibited substances by federations and international institutions of sport. The legalization and resulting production, and commercialization of CBD, could increase its intake in sports professionals. This commercialization of cannabinoids has fueled a race to study their properties, benefits, and risks for health and performance in athletes. Although there is evidence that suggests some beneficial properties such as anxiolytics, antidepressants, anti-inflammatory, and antioxidants among others, the evidence presented so far is neither clear nor conclusive. There are significant gaps in knowledge of the physiological pathways that explain the role of CBD in sports performance. This mini-review examines evidence suggesting that CBD has the potential to be used as a part of the strategies to recover from fatigue and muscle damage related to physical and cognitive exertion in sports.

Effect of Tart Cherry on Aromatase Inhibitor-Induced Arthralgia (AIA) in Nonmetastatic Hormone-Positive Breast Cancer Patients: A Randomized Double-Blind Placebo-Controlled Trial

BACKGROUND

Aromatase Inhibitor induced Arthralgia (AIA) can cause noncompliance leading to decreased breast-cancer survival. Effective interventions for AIA are limited. Tart cherry (TC) showed beneficial effect on musculoskeletal pain. 48 patients (Pts) randomized to TC versus placebo over 6 weeks, TC (23pts) had 34.7% mean pain decrease versus 1.4% in Placebo (25pts). TC can improve AIA in nonmetastatic breast-cancer patients.

METHODS

Randomized, placebo-controlled, double-blind trial. Eligible patients with NMHPBC on AI for at least 4 weeks were randomized to TC concentrate [50 tart cherries] vs. placebo (P) [syrup] in 1:1 model. Patients instructed to consume 1 Oz of concentrate in 8 Oz water daily for 6 weeks, and document their pain intensity at baseline, weekly and at study completion in a diary using Visual Analog Scale (VAS), with 0 mm indicating no pain, and 100 mm indicating highest pain.

RESULTS

Sixty patients were enrolled. Two patients did not complete the study due to diarrhea, and 10 patients were noncompliant. Forty-eight patients were included in the final analysis. TC group (23 pts) had 34.7% mean decrease in pain compared to 1.4% in P group (25 pts). This difference was statistically significant (Mann-Whitney U Test, P = .034).

CONCLUSIONS

Tart cherry can significantly improve AIA in nonmetastatic breast cancer patient.

Plasma uptake of selected phenolic acids following New Zealand blackcurrant extract supplementation in humans

New Zealand blackcurrant (NZBC) extract is a rich source of anthocyanins and in order to exert physiological effects, the anthocyanin-derived metabolites need to be bioavailable in vivo. We examined the plasma uptake of selected phenolic acids following NZBC extract supplementation alongside maintaining a habitual diet (i.e. not restricting habitual polyphenol intake). Twenty healthy volunteers (nine females, age: 28 ± 7 years, height 1.73 ± 0.09 m, body mass 73 ± 11 kg) consumed a 300 mg NZBC extract capsule (CurraNZ^®; anthocyanin content 105 mg) following an overnight fast. Venous blood samples were taken pre and 1, 1.5, 2, 3, 4, 5, and 6 h post-ingestion of the capsule. Reversed-phase high-performance liquid chromatography (HPLC) was used for analysis of two dihydroxybenzoic acids [i.e. vanillic acid (VA) and protocatechuic acid (PCA)] and one trihydroxybenzoic acid [i.e. gallic acid (GA)] in plasma following NZBC extract supplementation. Habitual anthocyanin intake was 168 (95%CI:68-404) mg⋅day^-1 and no associations were observed between this and VA, PCA, and GA plasma uptake by the NZBC extract intake. Plasma time-concentration curves revealed that GA, and PCA were most abundant at 4, and 1.5 h post-ingestion, representing a 261% and 320% increase above baseline, respectively, with VA remaining unchanged. This is the first study to demonstrate that an NZBC extract supplement increases the plasma uptake of phenolic acids GA, and PCA even when a habitual diet is followed in the days preceding the experimental trial, although inter-individual variability is apparent.

Does Flavonoid Consumption Improve Exercise Performance? Is It Related to Changes in the Immune System and Inflammatory Biomarkers? A Systematic Review of Clinical Studies since 2005

Flavonoids are attracting increasing attention due to their antioxidant, cardioprotective, and immunomodulatory properties. Nevertheless, little is known about their role in exercise performance in association with immune function. This systematic review firstly aimed to shed light on the ergogenic potential of flavonoids. A search strategy was run using SCOPUS database. The returned studies were screened by prespecified eligibility criteria, including intervention lasting at least one week and performance objectively quantified, among others. Fifty-one studies (54 articles) met the inclusion criteria, involving 1288 human subjects, either physically untrained or trained. Secondly, we aimed to associate these studies with the immune system status. Seventeen of the selected studies (18 articles) assessed changes in the immune system. The overall percentage of studies reporting an improved exercise performance following flavonoid supplementation was 37%, the proportion being 25% when considering quercetin, 28% for flavanol-enriched extracts, and 54% for anthocyanins-enriched extracts. From the studies reporting an enhanced performance, only two, using anthocyanin supplements, focused on the immune system and found certain anti-inflammatory effects of these flavonoids. These results suggest that flavonoids, especially anthocyanins, may exert beneficial effects for athletes’ performances, although further studies are encouraged to establish the optimal dosage and to clarify their impact on immune status.

Review of Analytical Methods and Reporting of the Polyphenol Content of Tart Cherry Supplements in Human Supplementation Studies Investigating Health and Exercise Performance Effects: Recommendations for Good Practice

Tart cherries (TC) are a rich source of polyphenols that elicit antioxidant and anti-inflammatory effects. As a consequence, the effects of TC derived supplements on markers of human health, exercise performance and sleep have been investigated. Supplementation protocols have been highly variable across studies and the dose of bioactive compounds used has often been poorly characterized. Specific and non-specific analytical methods were employed for measuring the total polyphenol and anthocyanin content in TC supplements. This review critically analyses the supplementation protocols and the analytical methods used for the characterization of TC supplements, culminating in recommendations for good practice in the analysis and reporting of the polyphenol content and profile of TC products. A literature search was conducted using PubMed/Medline and Web of Science up to May 4th, 2020, including studies published in all years prior. Only articles written in English that provided a TC dietary supplement as opposed to fresh whole TC were included in this review. Forty-three studies were identified as eligible and included for analysis in this review. The studies investigated the effects of TC supplementation on various aspects of human health, exercise recovery and performance and sleep. Twenty studies conducted an analysis of TC supplement and reported total polyphenol/anthocyanin content. Six studies did not report the polyphenol content of the TC supplement used. Seventeen studies reported the TC supplement polyphenol content but this was derived from previously published studies and presumably different supplement batches. The duration of the supplementation protocol ranged from acute supplementation to 84 days, meanwhile the total polyphenol and anthocyanin dose ranged from 143 to 2,140 mg/day and 15 to 547 mg/day, respectively. Due to the variety of specific and non-specific analytical methods used, the relative efficacy of different doses and polyphenol blends cannot reliably be extrapolated from critical analysis of the literature. Future studies should conduct an analysis of the study supplement batch. In addition to analysis and reporting of total polyphenol content, specific analytical methods such as HPLC UV/MS should be used to quantify total and individual anthocyanin contents.

U.S. Montmorency Tart Cherry Juice Decreases Bone Resorption in Women Aged 65-80 Years

Pre-clinical studies have demonstrated that tart cherries, rich in hydroxycinnamic acids and anthocyanins, protect against age-related and inflammation-induced bone loss. This study examined how daily consumption of Montmorency tart cherry juice (TC) alters biomarkers of bone metabolism in older women. Healthy women, aged 65–80 years (n = 27), were randomly assigned to consume ~240 mL (8 fl. oz.) of juice once (TC1X) or twice (TC2X) per day for 90 d. Dual-energy x-ray absorptiometry (DXA) scans were performed to determine bone density at baseline, and pre- and post-treatment serum biomarkers of bone formation and resorption, vitamin D, inflammation, and oxidative stress were assessed. Irrespective of osteoporosis risk, the bone resorption marker, tartrate resistant acid phosphatase type 5b, was significantly reduced with the TC2X dose compared to baseline, but not with the TC1X dose. In terms of indicators of bone formation and turnover, neither serum bone-specific alkaline phosphatase nor osteocalcin were altered. No changes in thiobarbituric acid reactive substances or high sensitivity C-reactive protein were observed in response to either TC1X or TC2X. We conclude that short-term supplementation with the higher dose of tart cherry juice decreased bone resorption from baseline without altering bone formation and turnover biomarkers in this cohort.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Nutritional interventions for reducing the signs and symptoms of exercise-induced muscle damage and accelerate recovery in athletes: current knowledge, practical application and future perspectives

PURPOSE

This review provides an overview of the current knowledge of the nutritional strategies to treat the signs and symptoms related to EIMD. These strategies have been organized into the following sections based upon the quality and quantity of the scientific support available: (1) interventions with a good level of evidence; (2) interventions with some evidence and require more research; and (3) potential nutritional interventions with little to-no-evidence to support efficacy.

METHOD

Pubmed, EMBASE, Scopus and Web of Science were used. The search terms 'EIMD' and 'exercise-induced muscle damage' were individually concatenated with 'supplementation', 'athletes', 'recovery', 'adaptation', 'nutritional strategies', hormesis'.

RESULT

Supplementation with tart cherries, beetroot, pomegranate, creatine monohydrate and vitamin D appear to provide a prophylactic effect in reducing EIMD. β-hydroxy β-methylbutyrate, and the ingestion of protein, BCAA and milk could represent promising strategies to manage EIMD. Other nutritional interventions were identified but offered limited effect in the treatment of EIMD; however, inconsistencies in the dose and frequency of interventions might account for the lack of consensus regarding their efficacy.

CONCLUSION

There are clearly varying levels of evidence and practitioners should be mindful to refer to this evidence-base when prescribing to clients and athletes. One concern is the potential for these interventions to interfere with the exercise-recovery-adaptation continuum. Whilst there is no evidence that these interventions will blunt adaptation, it seems pragmatic to use a periodised approach to administering these strategies until data are in place to provide and evidence base on any interference effect on adaptation.

Deciphering the Role of Polyphenols in Sports Performance: From Nutritional Genomics to the Gut Microbiota toward Phytonutritional Epigenomics

The individual response to nutrients and non-nutrient molecules can be largely affected by three important biological layers. The gut microbiome can alter the bioavailability of nutrients and other substances, the genome can influence molecule kinetics and dynamics, while the epigenome can modulate or amplify the properties of the genome. Today the use of omic techniques and bioinformatics, allow the construction of individual multilayer networks and thus the identification of personalized strategies that have recently been considered in all medical fields, including sports medicine. The composition of each athlete’s microbiome influences sports performance both directly by acting on energy metabolism and indirectly through the modulation of nutrient or non-nutrient molecule availability that ultimately affects the individual epigenome and the genome. Among non-nutrient molecules polyphenols can potentiate physical performances through different epigenetic mechanisms. Polyphenols interact with the gut microbiota, undergoing extensive metabolism to produce bioactive molecules, which act on transcription factors involved in mitochondrial biogenesis, antioxidant systems, glucose and lipid homeostasis, and DNA repair. This review focuses on polyphenols effects in sports performance considering the individual microbiota, epigenomic asset, and the genomic characteristics of athletes to understand how their supplementation could potentially help to modulate muscle inflammation and improve recovery.

Cherry intake as a dietary strategy in sport and diseases: a review of clinical applicability and mechanisms of action

Cherries are fruits rich in phytochemical compounds, particularly anthocyanins. Thus, consumption of cherries has gained attention in both clinical and sport-related fields for their antioxidant and anti-inflammatory properties. Mechanistically, anthocyanins from the intake of cherries may help to attenuate pain and decrease blood concentrations of biomarkers linked to skeletal muscle degradation, which in turn may provide ergogenic effects. In addition, the ability of anthocyanins to balance the redox state represents a conceivable target for rheumatic disorders (e.g. gout and arthritis). Moreover, cherry anthocyanins are emerging as a potential non-pharmacological remedy for cardiometabolic diseases (hypertension and dyslipidemia). Herein, we summarize the effects of cherry intake in sport and diseases, and discuss their purported mechanisms of action to provide insights into practical application.

Effect of Tart Cherry Concentrate on Endurance Exercise Performance: A Meta-analysis

Objective: Tart cherry concentrate has been shown to improve muscle function, and reduce muscle damage, oxidative stress/inflammation, and muscle soreness in athletes; however, evidence for acute endurance performance benefits is scarce. The purpose of this review was to evaluate the effect of tart cherry juice on endurance exercise performance with a meta-analysis.Method: Data sources included Medline, Embase, Web of Science, and Google Scholar. Eligibility criteria were randomized controlled trials with endurance exercise performance tests. Participants were healthy individuals. Interventions included tart cherry supplementation and placebo ingested before, and/or on the day of exercise. Ten studies were included (totaling 127 males and 20 females). Standardized mean differences (SMD) with 95% confidence intervals were calculated for each study and pooled effects were assessed.Results: Tart cherry concentrate in juice or powdered form, ingested for 7 days to 1.5 hours before exercise performance testing significantly improved endurance exercise performance (SMD: 0.36; 95% CI: 0.07 to 0.64; p = 0.01; I² = 0%) upon pooling of the ten studies.Conclusions: Tart cherry concentrate has a significant benefit for endurance exercise performance. Key teaching pointsTart cherry concentrate has a significant benefit for endurance exercise performance.Tart cherry concentrate may enhance endurance exercise performance via its low glycemic index, anti-inflammatory and anti-oxidative capacity, and blood flow enhancing effects.

Nutritional and Pharmacological Interventions to Expedite Recovery Following Muscle-Damaging Exercise in Older Adults: A Narrative Review of the Literature

Exercise-induced muscle damage (EIMD) manifests as muscle soreness, inflammation, and reductions in force generating capacity that can last for several days after exercise. The ability to recover and repair damaged tissues following EIMD is impaired with age, with older adults (≥50 years old) experiencing a slower rate of recovery than their younger counterparts do for the equivalent exercise bout. This narrative review discusses the literature examining the effect of nutritional or pharmacological supplements taken to counter the potentially debilitating effects of EIMD in older adults. Studies have assessed the effects of nonsteroidal anti-inflammatory drugs, vitamin C and/or E, or higher protein diets on recovery in older adults. Each intervention showed some promise for attenuating EIMD, but, overall, there is a paucity of available data in this population, and more studies are required to determine the influence of nutrition or pharmacological interventions on EIMD in older adults.

Impact of anthocyanin-rich whole fruit consumption on exercise-induced oxidative stress and inflammation: a systematic review and meta-analysis

CONTEXT

Supplementing with fruits high in anthocyanins to reduce exercise-induced oxidative stress and inflammation has produced mixed results.

OBJECTIVE

This systematic review and meta-analysis aims to discuss the impact of whole fruits high in anthocyanins, including processing methods and the type and amount of fruit, on inflammation and oxidative stress.

DATA SOURCES

PICOS reporting guidelines and a customized coding scheme were used to search 5 databases (SPORTDiscus, Science Direct, Web of Science [BIOSIS], Medline [Pubmed], and the Cochrane Collaboration) with additional cross-referencing selection.

DATA EXTRACTION

A random-effects meta-analysis was used to measure effects of the fruit supplements with 3 statistics; the QTotal value based on a χ2 distribution, τ2 value, and I2 value were used to determine homogeneity of variances on 22 studies (out of 807). Outliers were identified using a relative residual value.

RESULTS

A small significant negative summary effect across the sum of all inflammatory marker outcomes (P < 0.001) and a moderate negative effect for the sum of all oxidative stress marker outcomes (P = 0.036) were found. Moderator analyses did not reveal significant (P > 0.05) differences between subgrouping variables.

CONCLUSIONS

Results indicate that consumption of whole fruit high in anthocyanins can be beneficial for reducing inflammation and oxidative stress.

Effect of Tart Cherry Polyphenols on Osteoclast Differentiation and Activity

Bone is maintained by an intricate balance between bone formation and bone resorption. The presence of inflammation can contribute to an imbalance in bone homeostasis by enhancing differentiation and activity of osteoclasts, the cells that participate in the breakdown of bone. Polyphenols such as flavonoids found in plant-derived foods have been shown to have anti-inflammatory effects in various tissues. Tart cherries are a rich source of such polyphenolic compounds. Using mouse macrophage cells (RAW 264.7), we examined whether tart cherry polyphenols could dose dependently inhibit the proliferation and activity of receptor activator of nuclear factor kappa-B ligand (RANKL) differentiated osteoclasts under inflammatory conditions. Tartrate-resistant acid phosphatase (TRAP) activity and staining of TRAP-positive multinucleated cells, used as indicators of osteoclast differentiation and activity, tended to decrease with tart cherry polyphenols treatment. Osteoprotegerin expression by osteoclasts was decreased in a similar manner. A significant increase in nitrite concentration was observed with the lower doses of tart cherry polyphenols of 50 and 100 μg/mL (P < .05). However, higher doses of tart cherry polyphenols (200 and 300 μg/mL) reduced nitrite concentrations below that of the control that received no tart cherry polyphenols treatment (P < .05). Western blot analyses showed that protein expression of cyclooxygenase-2 (COX-2) followed a similar trend, although results were not statistically significant. On the other hand, tart cherry polyphenols treatments dose dependently increased inducible nitric oxide synthase protein expression, with statistical significance noted at doses of 200 and 300 μg/mL. Overall, our findings suggest that the polyphenols associated with tart cherries potentially inhibit osteoclast differentiation and activity, which may be beneficial to bone health.

Nutrients, Bioactive Compounds and Bioactivity: The Health Benefits of Sweet Cherries (Prunus avium L.)

Background:

Sweet cherries are one of the most appreciated fruits worldwide as well as one of the great sources of several active substances, as phytochemical compounds (carotenoids, serotonin, melatonin and phenolic compounds) as well as in nutritive compounds (sugars and organic acids). Accumulating research demonstrate that their supplementation in our daily diet can contradict oxidative stress, mitigating or even attenuating chronic diseases, as cancerous processes, antiinflammatory- related disorders, diabetes, and neurological and cardiovascular pathologies. Therefore, the aims of this review are to present an overview on the effects of sweet cherries as health promotors, giving emphasis to the health benefits of their bioactive compounds, particularly their antimicrobial, antioxidant, antidiabetic, anticancer, anti-neurodegeneration, anti-inflammatory and cardiovascular effects.

Methods:

Research and online content about sweet cherry fruits is reviewed. The information available has been read several times to avoid inconsistencies. In addition, according what we read, original figures were done and added to facilitate understanding and to enrich the paper.

Results:

In this review, a total of 202 original reports were used. In respect to health benefits, it is possible to confirm by several studies that, in fact, the consumption of sweet cherries has positive impacts in human health, owing to their wealthy and vast constitution, particularly in phenolic compounds, vitamins and carotenoids whose health properties were already documented.

Conclusion:

The findings of this review support the evidence that sweet cherries can be applied in pharmaceutical and food formulations, since they are able to diminish free radical species and proinflammatory markers, preventing and/ or ameliorating oxidative-stress disorders.

Cherry Gel Supplementation Does Not Attenuate Subjective Muscle Soreness or Alter Wellbeing Following a Match in a Team of Professional Rugby Union players: A Pilot Study

This study examined the effects of sour tart cherry juice (TC) on muscle soreness (MS) and wellbeing following a rugby union match in professional players. In a crossover design, 10 players from a senior squad in the top tier of England consumed either 2 × 30 mL servings of TC or an isocaloric cherry-flavoured control gel (CON) two days before, the day of, and two days following an 80 min match. Subjective wellbeing and MS were measured before the match (Pre), and for three days following the match (M+1, M+2, and M+3, respectively). MS was elevated from Pre at M+1 (CON, 111 ± 37 mm vs. TC 94 ± 41 mm) and M+2 (CON, 81 ± 35 mm vs. TC 72 ± 36 mm) (time effect; p = 0.0001; ηp² = 0.821) but there were no differences between TC and CON at either time point post-exercise (p = 0.807; ηp² = 0.035). Wellness scores were ~15% lower at M+1 (p = 0.023; ηp² = 0.638) but there were no differences between the two conditions at any time point (p = 0.647; ηp² = 0.160). In conclusion, tart cherry juice did not attenuate soreness or alter wellbeing in a team of professional rugby union players following a competitive match.

Tart cherry consumption with or without prior exercise increases antioxidant capacity and decreases triglyceride levels following a high-fat meal

Exercise and high-phytonutrient foods may lower oxidative stress and increase antioxidant levels, which could combat the negative effects associated with a high-fat (HF) meal. The objective of this study is to test the effects of Montmorency tart cherry (Prunus cerasus L.) consumption, with or without aerobic exercise, on antioxidant responses to an HF meal. Twelve normal-weight men (aged 22 ± 3 years), participated in a randomized crossover design comprising 4 trials: (i) HF meal with Montmorency tart cherry consumption (MC), (ii) HF meal with placebo (P), (iii) exercise prior to HF meal with MC (E+MC), and (iv) exercise prior to HF meal with P (E+P). The HF meal contained 60 g of fat and was consumed with MC or P. For exercise trials, a 30-min bout of submaximal treadmill exercise was performed the afternoon prior to HF meal consumption. Antioxidant capacity and triglycerides (TG) levels were measured at baseline and at 1, 2, and 3 h postprandially. Postprandial antioxidant capacity as assessed by oxygen radical absorbance capacity was significantly higher after MC and E+MC compared with E+P (incremental area under the curve (iAUC): 2.95 ± 2.19 and 4.87 ± 1.45 vs. -1.02 ± 1.72 mmol Trolox equivalents/L for MC and E+MC vs. E+P, respectively; p < 0.01). Postprandial TG levels were significantly lower after E+MC compared with P (iAUC: 58.99 ± 19.46 vs. 107.46 ± 22.66 mmol Trolox equivalents/L for E+MC vs. P, respectively; p < 0.05). These results indicate that MC consumption alone, and in combination with prior exercise, leads to greater antioxidant capacity following an HF meal compared with prior exercise with placebo. Further, MC consumption with prior exercise led to more favorable postprandial TG levels compared with placebo.

Montmorency cherry supplementation improves 15-km cycling time-trial performance

Aim

Montmorency cherries are rich in polyphenols that possess antioxidant, anti-inflammatory and vasoactive properties. We investigated whether 7-day Montmorency cherry powder supplementation improved cycling time-trial (TT) performance.

Methods

8 trained male cyclists (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot {V}{{\text{O}}_{2{\text{peak}}}}$$\end{document}V˙O2peak: 62.3 ± 10.1 ml kg⁻¹ min⁻¹) completed 10-min steady-state (SS) cycling at ~ 65% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot {V}{{\text{O}}_{2{\text{peak}}}}$$\end{document}V˙O2peak followed by a 15-km TT on two occasions. Participants consumed 6 pills per day (Montmorency cherry powder, MC; anthocyanin 257 mg day⁻¹ or dextrose powder, PL) for a 7-day period, 3 pills in the morning and evening. Capillary blood [lactate] was measured at baseline, post SS and post TT. Pulmonary gas exchange and tissue oxygenation index (TOI) of m. vastus lateralis via near-infrared spectroscopy, were measured throughout.

Results

TT completion time was 4.6 ± 2.9% faster following MC (1506 ± 86 s) supplementation compared to PL (1580 ± 102 s; P = 0.004). Blood [lactate] was significantly higher in MC after SS (PL: 4.4 ± 2.1 vs. MC: 6.7 ± 3.3 mM, P = 0.017) alongside an elevated baseline TOI (PL: 68.7 ± 2.1 vs. MC: 70.4 ± 2.3%, P = 0.018).

Discussion

Montmorency cherry supplementation improved 15-km cycling TT performance. This improvement in exercise performance was accompanied by enhanced muscle oxygenation suggesting that the vasoactive properties of the Montmorency cherry polyphenols may underpin the ergogenic effects.

Sour Cherry By-products: Compositions, Functional Properties and Recovery Potentials - A Review

Sour (tart) cherry is an industrial fruit where a considerable amount of by-products remain after processing. Sour cherry by-products consist of pomace (skin and flesh) and seeds (pit, stone) which remain after the fruit juice and IQF processes. Sour cherry pomace is characterized with a high content of phenolic compounds and the seed constitutes a high oil yield with beneficial effects on human health because of their antioxidant, antimicrobial, and anti-inflammatory properties. There has been a great interest in sour cherry by-products due to the increasing production rate of sour cherry worldwide and the increasing efforts on seeking bioactive compounds from natural sources as functional food. Thus, there have been a number of studies regarding the sour cherry pomace and sour cherry seed, especially in the last five years. The present review summarizes the chemical, biological, functional, and technological properties of the sour cherry pomace and sour cherry seed with their current and potential applications.

Exercise-induced muscle damage: What is it, what causes it and what are the nutritional solutions?

Exercise-induced muscle damage (EIMD) is characterized by symptoms that present both immediately and for up to 14 days after the initial exercise bout. The main consequence of EIMD for the athlete is the loss of skeletal muscle function and soreness. As such, numerous nutrients and functional foods have been examined for their potential to ameliorate the effects of EIMD and accelerate recovery, which is the purpose of many nutritional strategies for the athlete. However, the trade-off between recovery and adaptation is rarely considered. For example, many nutritional interventions described in this review target oxidative stress and inflammation, both thought to contribute to EIMD but are also crucial for the recovery and adaptation process. This calls into question whether long term administration of supplements and functional foods used to target EIMD is indeed best practice. This rapidly growing area of sports nutrition will benefit from careful consideration of the potential hormetic effect of long term use of nutritional aids that ameliorate muscle damage. This review provides a concise overview of what EIMD is, its causes and consequences and critically evaluates potential nutritional strategies to ameliorate EIMD. We present a pragmatic practical summary that can be adopted by practitioners and direct future research, with the purpose of pushing the field to better consider the fine balance between recovery and adaptation and the potential that nutritional interventions have in modulating this balance.

Montmorency tart cherry (Prunus cerasus L.) supplementation accelerates recovery from exercise-induced muscle damage in females

Tart Montmorency cherry concentrate (MC) has been reported to attenuate the symptoms of exercise-induced muscle damage (EIMD) and to accelerate exercise recovery, which has been attributed to its high anti-inflammatory and antioxidant properties. Although these data are promising, there are no data regarding exclusively female populations. Therefore, the aim of this investigation was to examine the efficacy of MC on recovery following EIMD in females. In a randomised, double-blind, placebo-controlled study, twenty physically active females (mean ± SD age 19 ± 1 y; stature 167 ± 6 cm; body mass 61.4 ± 5.7 kg) consumed MC or a placebo (PL) for eight days (30 mL twice per day). Following four days of supplementation, participants completed a repeated-sprint protocol and measures of muscle soreness (DOMS), pain pressure threshold (PPT), limb girth, flexibility, muscle function, and systemic indices of muscle damage and inflammation were collected pre, immediately post (0 h) and 24, 48 and 72 h post-exercise. Time effects were observed for all dependent variables (p < 0.05) except limb girth and high sensitivity C-reactive protein. Recovery of countermovement jump height was improved in the MC group compared to PL (p = 0.016). There was also a trend for lower DOMS (p = 0.070) and for higher PPT at the rectus femoris (p = 0.071) in the MC group. The data demonstrate that MC supplementation may be a practical nutritional intervention to help attenuate the symptoms of muscle damage and improve recovery on subsequent days in females.

Impact of tart cherries polyphenols on the human gut microbiota and phenolic metabolites in vitro and in vivo

Tart cherries have been reported to exert potential health benefits attributed to their specific and abundant polyphenol content. However, there is a need to study the impact and fate of tart cherries polyphenols in the gut microbiota. Here, tart cherries, pure polyphenols (and apricots) were submitted to in vitro bacterial fermentation assays and assessed through 16S rRNA gene sequence sequencing and metabolomics. A short-term (5 days, 8 oz. daily) human dietary intervention study was also conducted for microbiota analyses. Tart cherry concentrate juices were found to contain expected abundances of anthocyanins (cyanidin-glycosylrutinoside) and flavonoids (quercetin-rutinoside) and high amounts of chlorogenic and neochlorogenic acids. Targeted metabolomics confirmed that gut microbes were able to degrade those polyphenols mainly to 4-hydroxyphenylpropionic acids and to lower amounts of epicatechin and 4-hydroxybenzoic acids. Tart cherries were found to induce a large increase of Bacteroides in vitro, likely due to the input of polysaccharides, but prebiotic effect was also suggested by Bifidobacterium increase from chlorogenic acid. In the human study, two distinct and inverse responses to tart cherry consumption were associated with initial levels of Bacteroides. High-Bacteroides individuals responded with a decrease in Bacteroides and Bifidobacterium, and an increase of Lachnospiraceae, Ruminococcus and Collinsella. Low-Bacteroides individuals responded with an increase in Bacteroides or Prevotella and Bifidobacterium, and a decrease of Lachnospiraceae, Ruminococcus and Collinsella. These data confirm that gut microbiota metabolism, in particular the potential existence of different metabotypes, needs to be considered in studies attempting to link tart cherries consumption and health.

IOC consensus statement: dietary supplements and the high-performance athlete

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition programme. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including (1) the management of micronutrient deficiencies, (2) supply of convenient forms of energy and macronutrients, and (3) provision of direct benefits to performance or (4) indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can benefit the athlete, but others may harm the athlete's health, performance, and/or livelihood and reputation (if an antidoping rule violation results). A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome and habitual diet. Supplements intended to enhance performance should be thoroughly trialled in training or simulated competition before being used in competition. Inadvertent ingestion of substances prohibited under the antidoping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount; expert professional opinion and assistance is strongly advised before an athlete embarks on supplement use.

IOC Consensus Statement: Dietary Supplements and the High-Performance Athlete

Nutrition usually makes a small but potentially valuable contribution to successful performance in elite athletes, and dietary supplements can make a minor contribution to this nutrition program. Nonetheless, supplement use is widespread at all levels of sport. Products described as supplements target different issues, including the management of micronutrient deficiencies, supply of convenient forms of energy and macronutrients, and provision of direct benefits to performance or indirect benefits such as supporting intense training regimens. The appropriate use of some supplements can offer benefits to the athlete, but others may be harmful to the athlete's health, performance, and/or livelihood and reputation if an anti-doping rule violation results. A complete nutritional assessment should be undertaken before decisions regarding supplement use are made. Supplements claiming to directly or indirectly enhance performance are typically the largest group of products marketed to athletes, but only a few (including caffeine, creatine, specific buffering agents and nitrate) have good evidence of benefits. However, responses are affected by the scenario of use and may vary widely between individuals because of factors that include genetics, the microbiome, and habitual diet. Supplements intended to enhance performance should be thoroughly trialed in training or simulated competition before implementation in competition. Inadvertent ingestion of substances prohibited under the anti-doping codes that govern elite sport is a known risk of taking some supplements. Protection of the athlete's health and awareness of the potential for harm must be paramount, and expert professional opinion and assistance is strongly advised before embarking on supplement use.

A Review of the Health Benefits of Cherries

Increased oxidative stress contributes to development and progression of several human chronic inflammatory diseases. Cherries are a rich source of polyphenols and vitamin C which have anti-oxidant and anti-inflammatory properties. Our aim is to summarize results from human studies regarding health benefits of both sweet and tart cherries, including products made from them (juice, powder, concentrate, capsules); all referred to as cherries here. We found 29 (tart 20, sweet 7, unspecified 2) published human studies which examined health benefits of consuming cherries. Most of these studies were less than 2 weeks of duration (range 5 h to 3 months) and served the equivalent of 45 to 270 cherries/day (anthocyanins 55–720 mg/day) in single or split doses. Two-thirds of these studies were randomized and placebo controlled. Consumption of cherries decreased markers for oxidative stress in 8/10 studies; inflammation in 11/16; exercise-induced muscle soreness and loss of strength in 8/9; blood pressure in 5/7; arthritis in 5/5, and improved sleep in 4/4. Cherries also decreased hemoglobin A1C (HbA1C), Very-low-density lipoprotein (VLDL) and triglycerides/high-density lipoprotein (TG/HDL) in diabetic women, and VLDL and TG/HDL in obese participants. These results suggest that consumption of sweet or tart cherries can promote health by preventing or decreasing oxidative stress and inflammation.

Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control

PURPOSE

Cryotherapy is an increasingly popular recovery strategy used in an attempt to attenuate the negative impact of strenuous physical activity on subsequent exercise. Therefore, this study aimed to assess the effects of whole body cryotherapy (WBC) and cold water immersion (CWI) on markers of recovery following a marathon.

METHODS

Thirty-one endurance trained males completed a marathon. Participants were randomly assigned to a CWI, WBC or placebo group. Perceptions of muscle soreness, training stress and markers of muscle function were recorded before the marathon and at 24 and 48 h post exercise. Blood samples were taken at baseline, post intervention and 24 and 48 h post intervention to assess inflammation and muscle damage.

RESULTS

WBC had a harmful effect on muscle function compared to CWI post marathon. WBC positively influenced perceptions of training stress compared to CWI. With the exception of C-reactive protein (CRP) at 24 and 48 h, neither cryotherapy intervention positively influenced blood borne markers of inflammation or structural damage compared to placebo.

CONCLUSION

The findings show WBC has a negative impact on muscle function, perceptions of soreness and a number of blood parameters compared to CWI, contradicting the suggestion that WBC may be a superior recovery strategy. Further, cryotherapy is no more effective than a placebo intervention at improving functional recovery or perceptions of training stress following a marathon. These findings lend further evidence to suggest that treatment belief and the placebo effect may be largely responsible for the beneficial effects of cryotherapy on recovery following a marathon.

Tart Cherries and health: Current knowledge and need for a better understanding of the fate of phytochemicals in the human gastrointestinal tract

Tart cherries are increasingly popular due to purported health benefits. This Prunus cesarus species is cultivated worldwide, and its market has increased significantly in the last two decades due to improvements in agricultural practices and food processing technology. Tart cherries are rich in polyphenols, with a very specific profile combining anthocyanins and flavonols (berries-like) and chlorogenic acid (coffee-like). Tart cherries have been suggested to exert several potentially beneficial health effects including: lowering blood pressure, modulating blood glucose, enhancing cognitive function, protecting against oxidative stress and reducing inflammation. Studies focusing on tart cherry consumption have demonstrated particular benefits in recovery from exercise-induced muscle damage and diabetes associated parameters. However, the bioconversion of tart cherry polyphenols by resident colonic microbiota has never been considered, considerably reducing the impact of in vitro studies that have relied on fruit polyphenol extracts. In vitro and in vivo gut microbiota and metabolome studies are necessary to reinforce health claims linked to tart cherries consumption.

A case of severe nephrotoxicity associated with long-term dietary supplement use

Dietary supplements are widely used for their perceived health benefits without side effects and hence have minimal regulation. However, they have been associated with various toxicities including kidney disease. We report a 65-year-old male who had very heavy daily intake of dietary supplements for 3 years. He presented with acute kidney injury and nephrotic-range proteinuria. The renal biopsy showed acute tubular necrosis with vacuolization, acute interstitial nephritis, and secondary membranous nephropathy, consistent with an non-steroidal anti-inflammatory drug (NSAID)-like nephropathy. This was postulated to be related to the cyclooxygenase (COX) inhibitors (anthocyanins) in cherry extract that was a significant part of the patient's dietary supplement use. His proteinuria completely resolved and serum creatinine stabilized after discontinuation of all dietary supplements and a prolonged (5 months) course of prednisone. Clinicians are advised to specifically inquire about dietary supplements, especially cherry extract, as a potential cause of new-onset renal failure and proteinuria.
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